Work Intensity and Fat Mass Percentage Are Associated with Asymptomatic Morphometric Vertebral Fractures in Knee Osteoarthritis Patients: A Cross-sectional Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2024 Sep 16

PMID 39283897

Authors

Izzatul Nadiah Zolkiply

Kah Keng Wong

Hakimah Mohammad Sallehudin

Mohammad Zulkarnain Bidin

Fahrudin Che Hamzah

Norafida Bahari

Wan Syamimee Wan Ghazali

Affiliations

Soon will be listed here.

Abstract

Knee osteoarthritis (OA) is a common condition with a prevalence of 365 million individuals globally, and it is an independent risk factor for falls and fractures, notably asymptomatic morphometric vertebral fractures (AMVF). The high prevalence of knee OA, the severity of AMVF, and their combined impacts on quality of life underscore the need for early detection, appropriate treatment and management. To address this, our cross-sectional study aims to identify potential predictive factors associated with AMVF in knee OA patients. Our cohort consisted of 76 patients diagnosed with knee OA, predominantly female (84.2%), of Malay ethnicity (84.2%), and obese (55.3%). In univariable analysis, significant association was found between occupation (moderate or heavy work) and AMVF (p<0.001). Diabetes mellitus comorbidity (p = 0.016) and fat mass percentage (p = 0.027) also demonstrated a significant association with AMVF in knee OA patients. Multivariable logistic regression analysis revealed that an increase in fat mass percentage resulted in decreased AMVF incidence (HR: 0.83, 95% CI: 0.70-0.97; p = 0.018), while occupation (moderate or heavy work) remained a highly significant predictor (HR: 57.76, 95% CI: 4.23-788.57; p = 0.002). These findings support the potential importance of considering occupational activities and body fat composition in managing AMVF among knee OA patients, but further research is required to establish causal relationships.

References

Bergink A, van der Klift M, Hofman A, Verhaar J, van Leeuwen J, Uitterlinden A . Osteoarthritis of the knee is associated with vertebral and nonvertebral fractures in the elderly: the Rotterdam Study. Arthritis Rheum. 2003; 49(5):648-57. DOI: 10.1002/art.11380. View

Arden N, Crozier S, Smith H, Anderson F, Edwards C, Raphael H . Knee pain, knee osteoarthritis, and the risk of fracture. Arthritis Rheum. 2006; 55(4):610-5. DOI: 10.1002/art.22088. View

Lingard E, Mitchell S, Francis R, Rawlings D, Peaston R, Birrell F . The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty. Age Ageing. 2009; 39(2):234-9. DOI: 10.1093/ageing/afp222. View

Guglielmi G, Ponti F, Agostini M, Amadori M, Battista G, Bazzocchi A . The role of DXA in sarcopenia. Aging Clin Exp Res. 2016; 28(6):1047-1060. DOI: 10.1007/s40520-016-0589-3. View

Shin C, Kim M, Shim S, Kim J, Yu S, Koo B . The prevalence and risk factors of vertebral fractures in Korea. J Bone Miner Metab. 2011; 30(2):183-92. DOI: 10.1007/s00774-011-0300-x. View

Phan C, Guglielmi G . Metabolic Bone Disease in Patients with Malabsorption. Semin Musculoskelet Radiol. 2016; 20(4):369-375. DOI: 10.1055/s-0036-1592429. View

Ebrahimzadeh M, Makhmalbaf H, Birjandinejad A, Golhasani Keshtan F, Hoseini H, Mazloumi S . The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis. Arch Bone Jt Surg. 2014; 2(1):57-62. PMC: 4151432. View

Bolland M, Siu A, Mason B, Horne A, Ames R, Grey A . Evaluation of the FRAX and Garvan fracture risk calculators in older women. J Bone Miner Res. 2010; 26(2):420-7. DOI: 10.1002/jbmr.215. View

Yeap S, Thambiah S, Suppiah S, Md-Said S, Appannah G, Samsudin I . Asymptomatic morphometric vertebral fractures and its associated factors: A cross-sectional study among adults in a selected urban area in Selangor, Malaysia. PLoS One. 2021; 16(7):e0255069. PMC: 8297745. DOI: 10.1371/journal.pone.0255069. View

10.

Parsons C, Gates L, Perry T, Nevitt M, Felson D, Sanchez-Santos M . Predominant lifetime occupation and associations with painful and structural knee osteoarthritis: An international participant-level cohort collaboration. Osteoarthr Cartil Open. 2022; 2(4):100085. PMC: 9718216. DOI: 10.1016/j.ocarto.2020.100085. View

11.

Cui A, Li H, Wang D, Zhong J, Chen Y, Lu H . Global, regional prevalence, incidence and risk factors of knee osteoarthritis in population-based studies. EClinicalMedicine. 2021; 29-30:100587. PMC: 7704420. DOI: 10.1016/j.eclinm.2020.100587. View

12.

Genant H, Wu C, van Kuijk C, Nevitt M . Vertebral fracture assessment using a semiquantitative technique. J Bone Miner Res. 1993; 8(9):1137-48. DOI: 10.1002/jbmr.5650080915. View

13.

Salamone L, Fuerst T, Visser M, Kern M, Lang T, Dockrell M . Measurement of fat mass using DEXA: a validation study in elderly adults. J Appl Physiol (1985). 2000; 89(1):345-52. DOI: 10.1152/jappl.2000.89.1.345. View

14.

Chan M, Frost S, Center J, Eisman J, Nguyen T . Relationship between body mass index and fracture risk is mediated by bone mineral density. J Bone Miner Res. 2014; 29(11):2327-35. DOI: 10.1002/jbmr.2288. View

15.

Genant H, Jergas M, Palermo L, Nevitt M, Valentin R, Black D . Comparison of semiquantitative visual and quantitative morphometric assessment of prevalent and incident vertebral fractures in osteoporosis The Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1996; 11(7):984-96. DOI: 10.1002/jbmr.5650110716. View

16.

Zhang X, Pan X, Deng L, Fu W . Relationship between Knee Muscle Strength and Fat/Muscle Mass in Elderly Women with Knee Osteoarthritis Based on Dual-Energy X-Ray Absorptiometry. Int J Environ Res Public Health. 2020; 17(2). PMC: 7013934. DOI: 10.3390/ijerph17020573. View

17.

Kwok A, Leung J, Chan A, Au B, Lau E, Yurianto H . Prevalence of vertebral fracture in Asian men and women: comparison between Hong Kong, Thailand, Indonesia and Japan. Public Health. 2012; 126(6):523-31. DOI: 10.1016/j.puhe.2012.03.002. View

18.

Muraki S, Akune T, Oka H, En-yo Y, Yoshida M, Saika A . Health-related quality of life in subjects with low back pain and knee pain in a population-based cohort study of Japanese men: the Research on Osteoarthritis Against Disability study. Spine (Phila Pa 1976). 2011; 36(16):1312-9. DOI: 10.1097/BRS.0b013e3181fa60d1. View

19.

Lee S, Kim T, Kim S . Sarcopenic obesity is more closely associated with knee osteoarthritis than is nonsarcopenic obesity: a cross-sectional study. Arthritis Rheum. 2012; 64(12):3947-54. DOI: 10.1002/art.37696. View

20.

Li G, Yin J, Gao J, Cheng T, Pavlos N, Zhang C . Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. Arthritis Res Ther. 2013; 15(6):223. PMC: 4061721. DOI: 10.1186/ar4405. View